Fertility Counseling for Transgender Adolescents: A Review


      International guidelines in transgender health recommend fertility counseling before the commencement of puberty suppression, estrogen, or testosterone, given the potential for these treatments to impair fertility. However, these recommendations provide little actual guidance to clinicians. Consequently, differences in knowledge and attitudes may lead to clinicians adopting different approaches and goals in the fertility counseling they provide. This review draws attention to the disparity between the rates of desire for genetic parenthood among transgender individuals and the actual rates of fertility preservation (FP) and examines different factors in fertility counseling that affect clinical practice and contribute to this disparity. These factors include how a lack of strong evidence—for the effects of hormone therapy on future fertility and success rates of some FP options—impacts upon counseling, transgender peoples' experiences of fertility counseling and preservation, consideration of a young person's developmental stage and the roles of parents and clinicians in the decision-making process, considerations shaping transgender adolescents' decisions to preserve fertility, and access barriers to FP. In doing so, this review highlights the complexities and issues that clinicians must consider when providing fertility counseling to transgender adolescents and—in part—helps to address the lack of detailed clinical guidelines in this area.


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        Journal of Adolescent HealthVol. 66Issue 6
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          Lesbian, gay, bisexual, transgender, and queer or questioning (LGBTQ) Pride Month is marked with parades, demonstrations, workshops, and other events to recognize the local and global impact of LGBTQ individuals. This month also reminds us to honor those within the LGBTQ community who we have lost and reflect on our past and present struggles for human rights. Our history is rich in examples of how the LGBTQ community has fought for these rights: Compton Cafeteria Riots in San Francisco, Stonewall Riots in New York, demonstrations by the AIDS Coalition to Unleash Power to prompt governmental response for the AIDS epidemic, and the fight for same-sex marriage.
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